A 45-year-old woman develops avascular necrosis of the femoral head after an intracapsular fracture of the neck of the femur. In the adult, the chief arterial supply to the head of the femur comes from which vessel?

• A Medial circumflex femoral artery ✓
• B Artery of the ligamentum teres
• C Lateral circumflex femoral artery
• D Inferior gluteal artery

Explanation

In adults the femoral head is supplied mainly by retinacular branches from the medial circumflex femoral artery, which pass along the posterosuperior aspect of the neck inside the capsule. An intracapsular fracture tears these retinacular vessels, causing avascular necrosis. The artery of the ligamentum teres, a branch of the obturator artery, is significant in childhood but contributes little in adults, which makes option B the classic distractor. The lateral circumflex femoral artery supplies mostly the anterolateral trochanteric region.

Reference: Snell's Clinical Anatomy by Regions, 10th ed.

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